Design Problem Knee related injuries: Most common sports-career ending injury Post-ACL Surgery:...
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Transcript of Design Problem Knee related injuries: Most common sports-career ending injury Post-ACL Surgery:...
Design Problem
Knee related injuries: • Most common sports-career ending
injury
Post-ACL Surgery: • Pain, scar tissue, muscle atrophy,
decreased proprioception
Physical therapy: • Important for full recovery
Problem
Difficult and expensive to restore injured
knee to pre-injury functionality.
http://www.leefalin.com/wp-images/acl.jpg
Background & Demographics
Background
• The average cost of ACL reconstruction ~$11,500
• Total cost of recovery ~ $30,000
• Recovery time can be up to 6 months
• Out-patient physical therapy 1-2 visits/week• Check progress, review and modify program
• Patient Overexertion/Non-Compliance• Poor results• Re-injury
http://tinyurl.com/3dzgqt
Jerry Rice
Rice's 2nd Knee InjuryEnds a Lost Season
The New York Times
Rice's 2nd Knee InjuryEnds a Lost Season
The New York Times
MethodProvide an suitable exercise regimen coupled with sensors to:
• Display physiological measurements for real-time biofeedback• Record these signals for later evaluation by health care
providers
Design Brief
SolutionDevelop an integrated exercise
device for a more autonomous rehabilitation.
Basic Principles
• 6-8 weeks• Control swelling• Regain R.O.M., muscle strength• PT visits few times per week• Exercise 30-60 minutes per day
• 2-4 months• Stability and balance training• Less frequent PT sessions• Weight machines, exercise bicycles or treadmills
• Several months• Full R.O.M.• Normal muscle strength, no swelling• Continue stability, balance and strength training
Phase 1 Phase 2 Phase 3
General Rehab Process
http://tinyurl.com/2gxw2l
Target Muscle Groups Rehabilitation Metrics
• Qualitative assessment• Cincinnati Knee Rating System • QOL Questionnaire for ACL Deficiency• Manual manipulation
• Quantitative assessment • Surface/Needle EMG• Range of Motion• Volume of exercise
http://www.orthoassociates.com/ACL_Rehab_protocol.htm
Reliability & Accuracy• Must collect EMG data reliably and accurately enough to distinguish
between a functioning knee and a sub-functioning knee
Usability• Must be intuitive, accessible, and attractive to use
Simple User Interface• User interface/data output must be easy to understand and analyze by
both the user and the professional
Cost • Must not be prohibitively expensive - $5000 or less to build / $10,000 or
less to purchase (to be subsidized by insurance company)
Business Model• Initially sold to physical therapy facilities or doctor’s offices, possibly rented
out for home use• Potential for partnership with an exercise equipment company• Disposables - Electrodes
Constraints & Specifications
Components
Exercise equipment
Sensors
Display
Data transfer
Bike EllipticalLeg press
Surface EMG Goniometer Knee cuff
Exercise data
Waist pack
Muscle firing (EMG)
Bluetooth
Idea 1
Components• Elliptical trainer• Surface EMG• Bluetooth
Targeted Muscles• Calves• Gluteal• Hamstrings• Quadriceps
Partial-weight bearing• Lower joint loading
Drawbacks• Less common
ORTHOMETRICSSmart Elliptical Trainer 2007®
Idea 2
*Serrão F, et al. “Effect of tibia rotation on the electromyographical activity of the vastus medialis oblique and vastus lateralis longus muscles during isometric leg press.” Physical Therapy in Sport. 6(1) 15-23 (2005).
Components• Leg press• Surface EMG• Goniometry • Bluetooth/Wifi
Targeted Muscles• Quadriceps• Gluteus Maximus• Hamstrings
Physical Therapy • Phase II and later• Drawbacks*
ORTHOMETRICSLeg Press Trainer 2007®
surface EMG electrodesurface EMG electrode
user interfaceuser interface
Idea 3
ORTHOMETRICSBike Trainer 2007®
bluetooth/wifi antennabluetooth/wifi antenna
Exercise equipmentExercise equipment
Summary
BiosensorsBiosensors
Data processingData processing
User friendly efficientguided
rehab program
User friendly efficientguided
rehab program
Dr. William MacaulayOrthopedic Surgeon, Columbia University Medical CenterDirector of Center for Hip and Knee Replacement
Dr. Ranjan GuptaDepartment Chair of Orthopaedic Surgery, UC Irvine Professor of Orthopaedics, Anatomy & Neurobiology, and
BME
James GossettAssociate Athletic Director, Columbia University
Dr. Evan JohnsonDirector of Physical Therapy at the Spine CenterAdministrative Director of the Spine Center
Julianne CostaOccupational Therapist RegisteredPhysical Therapist
Dr. Tim WrightOrthopaedic Biomechanics and Biomaterials Hospital of Special Surgery
Thank You
Dr. Clark HungAssociate Professor of Biomedical
Engineering
Dr. Elizabeth HillmanAssistant Professor of Biomedical
Engineering
Keith YeagerSenior Staff Associate, Laboratory
Manager